articles

When Silence is More Than Shy

by Robin Starkey Harpster, MA MFT, Institute for Girls' Development

January 26, 2012

When I was a kid I was super shy. I was one of those kids that would react in silly, awkward ways when asked a question in front of a group of people. I remember the agony of oral reports, the heat of embarrassment evidenced in my scarlet red cheeks. It wasn’t until college and graduate school that I began to gain my confidence. And now as an adult, I have my red-faced moments, but for the most part I’ve “grown out of” the extreme shyness I felt as a second grader, afraid to raise my hand.

My experience may seem all too familiar to many kids. And for others (about 7 in 1000) what we think of as extreme shyness is actually an anxiety-based disorder called Selective Mutism (SM). SM is characterized by a consistent and ongoing failure to speak in specific social situations (Selective Mutism Group). Often times kids that are vibrant and talkative at home will become silent and unable to speak once they get to school, or girls scouts, or when asked a seemingly innocuous question by the cashier at the grocery store.

Selective Mutism is not a disorder that gets a lot of press, even though recent studies are indicating that it is as common or more so than autism. Experts are still unsure of its true origin, but brain research is indicating that kids with SM seem to have an over-reactive fear response. This explains the “freeze” we often see in kids with SM. Their bodies are reacting to the stress hormones that are released when they sense a perceived threat.

In my work treating SM, I find that there is a tricky balance between support and challenge. While treatment may incorporate many of the traditional therapies for treating other anxiety disorders, such as behavioral therapy and medication, it is a unique disorder that requires a specialized approach. Treatment should include all the support networks available to the child and collaboration between school, parent and therapist. Without treatment SM is not something that typically goes away on it’s own. It’s more likely to morph into a more challenging and potentially chronic disorder such as depression, social phobia or generalized anxiety in adolescence and adulthood. It generally is not something children simply “grow out of.”

It is also important to consider the potential risk to a child’s day-to-day quality of life, social development and future success without treatment. Think of all the questions in a year that go unanswered and unasked in a school environment. The children and teens I work with who struggle with SM make me aware of the many opportunities for learning and growing missed day in and day out. Teens with SM struggle more than their peers with learning the nuances of friendships and social interactions.  Yet effective relational skills are more and more important as they hope to launch careers and engage in intimate relationships. The risk of waiting it out seems all too dangerous a game to play.

Early intervention is key.  Because this is a disorder that typically manifests in a school environment it is often discovered once a child begins preschool or early elementary school. It is then important to find a qualified support person who is able and willing to be patient in finding and utilizing the appropriate tools to support the unique child. If this sounds at all like a child you know, here are some resources for beginning to help a silent child find their voice:

Selective Mutism Group

Selective Mutism Network

Helping Your Child With Selective Mutism by McHolm, Cunningham and Vanier

Have other questions about SM? Feel free to contact me via email at:

rharpstermft@instituteforgirlsdevelopment.com

Robin Starkey Harpster, MA is a Licensed Marriage and Family Therapist (MFC 41937) and Coordinator for The New and Young Families Program at the Institute for Girls’ Development in Pasadena, CA.

Contact: rharpstermft@instituteforgirlsdevelopment.com or follow her on Twitter: rharpstermft

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